An American entrepreneur runs a global career-coaching business from the Eternal City

ROME (Fortune Small Business) -- In a rented conference room near Emperor Hadrian's tomb, career coach Megan Fitzgerald greets two regular clients. Though all three are American expatriates, there's a good deal of Mediterranean-style cheek kissing. Then it's down to business on this bright February morning. Physician and first-time author Brian Rothbart, 65, and his wife, Linda Penzabene, 55, are unhappy about the dust jacket of their book, Forever Free From Chronic Pain. The colors are too dark, they fret.

"Well, it's close," soothes Fitzgerald, 38, a peppy New York City-born blonde. "Sometimes you've just got to embrace the 80% that works."

The couple turned to Fitzgerald after they relocated to Rome, where a local medical institute had offered Rothbart a research post. Before they signed on with Fitzgerald, Rothbart's Web site offered 450 pages of highly technical articles chronicling his 40-year search for a drug-free cure for chronic pain. Fitzgerald persuaded him to streamline his message and bypass the medical establishment. In the 2½ years they've worked together, meeting every other week, Fitzgerald has helped the couple launch a new site, write the book, find a publisher, start a Facebook page and make a DVD. Some mornings she e-mails them a to-do list, up to 20 items long.

"We're here to start a revolution," Fitzgerald says to Rothbart, leaning over the conference table. "You've spent your life coming up with incredible discoveries, transforming people's lives and releasing them from pain. We are here to empower people to take charge of their lives!"

As an American career coach in Rome, Fitzgerald is also on the front lines of a global revolution. Career coaching is a fast-growing and largely unregulated market. READ MORE